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VA suspends prostate cancer treatment programs at four hospitals

By Katherine McIntire Peters kpeters@govexec.com October 15, 2008

After a months-long inquiry into why dozens of prostate cancer treatment patients at the Veterans Affairs Medical Center in Philadelphia received lower-than-prescribed radiation doses, VA has suspended similar treatment programs at three other hospitals.

The three additional VA hospitals to suspend brachytherapy programs, in which radioactive seeds are implanted into the prostate, are in Cincinnati; Jackson, Miss.; and Washington. Those hospitals were found to have similar problems as those in Philadelphia, where the treatment program was suspended this summer.

News of the suspensions came from the Nuclear Regulatory Commission, which has launched a special inspection of VA's radiation treatment program. VA spokeswoman Laurie Tranter said she could not say when the programs were suspended, how patients were notified, or why the problems might have occurred.

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The agency planned to put out a press release late Wednesday or Thursday, she said. Until then she said she was not permitted to provide any details about the decision.

On Wednesday, NRC sent a letter to the Veterans Affairs National Health Physics Program documenting commitments made by VA to identify and address problems that have led to the medical errors and prevent their recurrence.

NRC will oversee VA operations to ensure the agency follows through on commitments to:

  • Conduct inspections at all 13 hospitals authorized to perform prostate cancer treatment.
  • Develop and implement standardized treatment procedures.
  • Identify causes of medical events and implement corrective actions.
  • Suspend any treatment program where 20 percent or more treatments have been identified as medical events.
  • Conduct an inspection to confirm all necessary corrective actions have been taken prior to restarting any treatment program.
  • Notify NRC of plans to restart programs.
  • Conduct an inspection of new prostate cancer treatment programs to confirm they meet enhanced standards.

"Facilities that use nuclear materials for medical treatment have a responsibility for administering treatments properly and safely," said James Caldwell, who heads up NRC's regional office in Lisle, Ill., which licenses VA's radiation treatment program.

Problems with the agency's prostate cancer treatment program first came to NRC's attention last May when VA's National Health Physics Program notified the regulatory body that a radiation dose delivered to a patient at the Philadelphia facility was less than 80 percent of what had been prescribed. The National Health Physics Program provides regulatory oversight for all radiation programs throughout the Veterans Affairs medical system.

A VA investigation subsequently found that 55 out of 112 prostate cancer treatment patients at the facility were underdosed between February 2002 and June 2008. Those findings triggered a special inspection by NRC.

The commission's investigation involves conducting independent inspections at several VA hospitals and evaluating the National Health Physics Program's response to the medical events.

NRC also has hired an independent medical consultant to examine possible health effects to patients.

Other VA hospitals that have prostate cancer treatment programs are located in Albany, N.Y.; Boston; Brooklyn, N.Y.; Durham, N.C.; Los Angeles; Minneapolis, Minn.; Richmond, Va.; San Francisco; and Seattle.

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COMMENTS

  • tell how can i receive 100% from the va i was medically retired from thhe army for prostate cancer they remove my entire gland and noe i suffer from ed among other problem gordon sanders Posted December 2, 2008 9:15 PM
  • Cudos to Rick Ward for the great explaination of what needs to be looked into. The procedure is a wonderful tool for those seeking Prostrate Cancer Treatment. Part of the key to success of the treatment is to seek it in the early stages. Postponing the treatment will most often require an inordinate number of seeds and the swelling following implant can cause other severe problems, lack of the ability to urinate being one. Even the MOST skilled oncologist do on occasion have to remove seeds from the bladder after implant. I had the opportunity to watch the procedure. I can say if I were a man and was faced with the diagnosis of prostate cancer...I would choose it. A key to obtaining compensation for service connected disability is personal involvement and a skilled, knowledgable advocate. If you are not fully involved and willing to work to obtain the needed information and documentation to prove your case, you are defeating yourself. When my husband was originally diagnosed with Agent Orange Connected cancer, he was on 100%. He did lose part of that after 2 years of remission. However, we have since won a permanent and total rating = 100%. It took work, but the end results were worth it. I will add that at no time was his treatment anything but excellent. Wife of 100% Disabled Vet Posted October 17, 2008 10:33 PM
  • This just solidifies that the VA is not your firend if you are a veteran. As a disabled veteran who has had to fight for compensation and treatment for a service connected disability for over 20 years, I never had one good experience with teh VA. I know that some people do - but women veterans receive a disaparate amount of compensation from the VA because after all - we can be somebody's wife and "be taken care of", where is the justice in that? It does not surprise me that veterans are receiving lower than normal does of treatment for prostate cancer - the VA is probably trying to save money. It would be interesting to find out the ages of those men who received the low doses - are they elderly and the VA had "written them off"? Where is GAO when you need it and what are they doing about the problems inherent in the VA? Kathy Posted October 17, 2008 8:39 AM
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